Ivan Barry Pless

Improvements in self-concept after treatment of nocturnal enuresis: Randomized controlled trial

To determine whether changes in attitude and behavior occur after treatment of nocturnal enuresis, we randomly assigned 121 children aged 8 to 14 years to receive conditioning therapy (n = 66) or a 3-month waiting period (n = 55). All children completed the Piers-Harris Self-Concept Scale (P-H), the State-Trait Anxiety Scale (STAIC), and the Nowicki-Strickland Locus of Control test (NSLC) at entry and after treatment or delay. Parents completed the Achenbach Child Behavior Checklist (CBCL). There were no significant group differences in background demographic variables. Significant improvements in the P-H Scale (P = 0.04) and three of its subscales occurred in children in the treatment group compared with those in whom treatment was delayed. The changes were greatest for those who had the largest decreases in wetting frequency. Changes in CBCL, STAIC, and NSLC scores were not statistically significant. We conclude that there may be mental health benefits in children helped to master the symptom of enuresis, which in this age group is probably a chronic stressor.

Locus of control in juvenile diabetic campers: changes during camp, and relationship to camp staff assessments

Locus of control was measured at the beginning and end of a three-week camp experience in 156 children with juvenile diabetes. The results were compared with those of 30 diabetic children who did not attend camp. Both the Nowicki Strickland Childrens Locus of Control and the Parcel Health Locus of Control scales were used. In addition, subjective assessments of diabetes management skills were made in all campers by several staff members. Significant changes toward internal locus of control on the NSLC but not the CHLC were found. The changes in NSLC seem to have persisted for at least one year in a small subsample of 23 children who were retested. Initial scores on both scales correlated moderately with the diabetes management skills ratings made at the end of camp. In view of the apparent importance of the locus of control construct in the self-care expected of most children with juvenile diabetes, the results should stimulate further efforts to examine the usefulness of this measure in relationship to achievement of good control of diabetes.

The Psychosocial Functioning of Young Adults Born with Cleft Lip or Palate A Follow-up Study

A follow-up study of 96 young adults born with a cleft lip and/or cleft palate was conducted to determine their present psychosocial adjustment and to evaluate the services offered to them. Medical histories were obtained from hospital charts. Telephone interviews focusing on educational achievement, work performance, and social integration showed that 10 to 33%, depending on the criteria used, experienced psychosocial maladjustment. There was a high rate of persistent dissatisfaction with appearance, hearing, speech, teeth, and social life. An analysis of the services offered to these young adults, in the light of their adjustment status and expressed needs, prompts the recommenda tion that counseling or other social support might be offered routinely during childhood and, of equal importance, during adolescence when further medi cal, surgical, and dental treatment may also be required.

Three basic convictions: a recipe for preventing child injuries

This paper represents a personal reflection on what is needed worldwide to prevent child injuries. It repeats messages that have been frequently delivered in the past. The main points are: first, the need for everyone to accept the view that, ultimately, injuries are a health problem and health departments must view them as such. Second, although increased and improved research is undoubtedly important, it is futile and frustrating if the results of existing research are not acted upon. Third, governments must play a central role by creating a national focus for the coordination and implementation of programmes whose value has been established. These points require widespread support if we hope to make genuine progress towards the goals reflected in this issue of the Bulletin.

Lessons From Health Trends for Systems of Child Health Care

ville in May 1992 was to help ensure that the pioneering efforts begun there would continue, thereby improving children’s health. An important t part of this process involves considering the system of care available to children. It is, however, only a part of the solution, and perhaps a much smaller part than most observers realize. Whenever systems of care are under consideration, politics inevitably enters the picture. Those who know Dr. Schiebler’s history will have

Changes at CMAJ.

As a Canadian physician, I am increasingly embarrassed. Undoubtedly, the firing of CMAJ ’s editor-in-chief and disbandment of the Journal Oversight Committee[1][1] is about money, not a falling reputation.[2][2]nnCMAJ is a source of pride and has been ever since John Hoey’s stewardship. In spite